[37F] With headache, facial pressure, and fever

Patient Description

A 37-year-old female presents with a throbbing headache rated 7/10, lasting for 3 days, accompanied by a hot face, low fever, pressure behind the eyes, nausea, and vomiting. The headache worsens upon transitioning from sleep to awake, bending over, or coughing, and is slightly relieved by Ibuprofen. She reports a history of meningitis and slight neck stiffness but no confusion or difficulty concentrating. Recent changes include a no-carb diet and long working hours. She started taking Prozac 20mg one week ago with no other side effects. She has asthma, diagnosed at age 6, and uses an Albuterol rescue inhaler. There are no known allergies, recent infections, or significant travel history. No changes in menstrual cycle or previous reactions to medications like Prozac.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

Sinus Headache or Sinusitis: The pressure behind your eyes, facial pain, and headache could suggest a sinus issue, even without congestion. Sinusitis can cause throbbing headaches that worsen with bending over or coughing.
- Treatment often includes decongestants, nasal sprays, or antibiotics if a bacterial infection is suspected.
Migraine: Throbbing headaches with nausea, sensitivity to light, and facial pain can indicate a migraine. Stress and dietary changes can trigger migraines.
- Treatment may involve over-the-counter pain relievers, prescription medications, and lifestyle modifications.
Medication Side Effects: Starting Prozac could potentially cause headaches and nausea as your body adjusts.
- These side effects often improve over time, but consult your doctor if they persist.
Tension Headache: Stress and long working hours can lead to tension headaches, characterized by a throbbing sensation and pressure.
- Treatment includes stress management, relaxation techniques, and pain relievers.

What you can do

Consult a Doctor: It's important to discuss your symptoms with a healthcare provider, especially given your history of meningitis.
Symptom Management: Continue using ibuprofen for pain relief, and consider using a warm compress for facial pain.
Hydration and Rest: Ensure you stay hydrated and get adequate rest to help your body recover.
Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

Seek Immediate Care: If you experience worsening neck stiffness, confusion, or a high fever, seek medical attention promptly.
Monitor Symptoms: If your symptoms persist or worsen, follow up with your healthcare provider.

Remember, this information is not a substitute for professional medical advice. Always consult a healthcare provider for a formal diagnosis and treatment plan.

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3 mo ago

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